Friday, May 30, 2008

Our Daily Meds

In her book, "Our Daily Meds," Melody Petersen has given us a new understanding about what's behind prescription drug advertising on television. Money, that's what's behind prescription drug advertising on television. Who knew? In Big Pharma it's called direct-to-consumer marketing, and the official pharma jargon for this is DTC. Beyond that, however, nobody (including the Big Pharma companies themselves) really understands much of anything, because most of the money is only going into the pocket of the PR firms that create the drug ads. For the pharmaceutical companies, the DTC experiment has been a mixed bag.

Take the recent case of Dr. Robert Jarvik, hyping Lipitor umpteen times a day on the TV in scenes that depicted him rowing and running. Working through the New York PR firm of the Kaplan Thaler Group, Pfizer paid Jarvik $1.35 million to be the mouthpiece for Lipitor. What Kaplan Thaler failed to mention in the advertisement was that Jarvik was not a rowing devotee (they used a body double for that scene), and Jarvik was not a runner, and Jarvik was not even licensed to practice medicine. Under pressure from the U.S. Congress and the pharma blogosphere, Pfizer eventually pulled the ad from TV in February of 2008. Both Pfizer and Dr. Jarvik suffered a substantial loss of reputation. As for Kaplan Thaler, it wasn't necessarily a sure bet that they'd be working on another Pfizer DTC commercial, but now it seems that they're the firm behind the Lyrica ads.

DTC advertising is relatively new. The FDA first allowed these prescription medicine advertisements to be shown on television in early 1997, and the Big Pharma players jumped on the opportunity like Dobermans on a prime rib roast. The high point for this DTC activity was reached about three years ago. In July of 2005, Pfizer was one of the top ten advertisers on television (the U.S. military is number one). Starting in August of 2005, Pfizer began cutting back, but the recent Jarvik debacle didn't intensify that pullback. Quite the opposite. With the lion's share of the industry's 5.1 billion-dollar TV ad budget, Pfizer is now actually on track to surpass the high water mark for TV ad spending set in early 2005. Meanwhile, Merck has been virtually absent from DTC activity after being forced to pull the Dorothy Hamill ads for Vioxx.

One of the main points of contention in DTC advertising concerns the issue of "risk advisement." The warnings of adverse side effects that accompany DTC ads are not the least bit informative or understandable for the average TV viewer who might need the medicine. Meanwhile, the Big Pharma players and the PR firms like Kaplan Thaler are only concerned with "compliance," meaning that they do just enough full disclosure to keep the FDA from pulling the ad. For this reason, as well as a host of other reasons, the pharma industry is taking it on the chin from the blogosphere and the Congress and the AARP. According to several market research polls conducted in 2006 and 2007, the pharmaceutical industry, handgun manufacturers, and tobacco companies are all held in the same low esteem in the court of public opinion. Big Pharma, generally perceived as an obscenely prosperous cash-cow, actually posted a measly 3.8% increase in 2007, and is on track to an equally anemic performance in 2008. The last time that the pharmaceutical industry showed numbers like this was in 1961. One extremely well-placed pharmaceutical industry insider has gone on record saying that, in his opinion, at least one of the major Big Pharma companies will completely disavow the use of DTC advertising by the end of 2009. If advertising for prescription drugs could be summed up with two words, they would be, "unfulfilled promise."

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